AIDS agencies brace for impact of Ryan White cuts

Apr 26, 2007

By John Wright Staff Writer

Support services such as food pantry and transportation services stand to lose thousands in operating funds under new federal guidelines

Volunteer Lionel Hillard, a Hurricane Katrina refugee, stocks a bread shelf at the AIDS Resource Food Pantry. Hillard said the pantry was invaluable to him when he fled New Orleans for Dallas. The pantry is one of many local HIV/AIDS support services threatened by recent changes to a federal funding program. (Photo by JOHN WRIGHT/Dallas Voice)

A Hurricane Katrina survivor, Lionel Hillard fled New Orleans to Dallas with nothing more than what he could carry on his back.

Fortunately, as a former vice chairman of the New Orleans Regional AIDS Planning Council, Hillard knew he could take advantage of support services like Dallas’ AIDS Resource Food Pantry.

“I lost virtually everything,” said Hillard, adding that this included his HIV medication.

“When you come here and you’re lost and you’re trying to get yourself situated, food is an essential component of getting healthy and staying healthy.”

The Food Pantry, where the 46-year-old Hillard now volunteers, provides groceries to 150 to 200 low-income HIV-positive clients each day.

But like many HIV/AIDS support services, the pantry is facing an uncertain future.

Support services which include food, transportation, housing, case management and legal aid have been the victim of severe cuts in federal funding over the last two years due to changes under the Ryan White HIV/AIDS Treatment Modernization Act of 2006.

Specifically, the updated act requires that 75 percent of funds under Ryan White the main source of government money for HIV/AIDS go to core medical care, while only 25 percent go to support services, which must be directly linked to medical outcomes.

Congress made the change because medical and pharmaceutical costs are rising as people with HIV/AIDS live longer.

But representatives from support services argue that without things like food, transportation and housing, medical care loses its effectiveness.

Bret Camp oversees the Food Pantry as associate executive director for health and medical services at the Resource Center of Dallas. Camp said he is unsure how much money the food pantry will actually lose, in part because Dallas County’s Department of Health and Human Services is still awaiting word on a portion of its Ryan White funding for 2007.

The county implemented the 75 percent/25 percent split for much of its Ryan White funds in 2006. That was in anticipation of the act’s passage, which came in December. However, now that the act is a mandate, and as the roughly $15 million in Dallas County Ryan White grants trickle in this year, support services are just beginning to come to grips with the consequences.

“It’s kind of scary for us,” Camp said. “Nothing is safe. We don’t know the impact that all this has yet.”

Steven Pace, executive director of the AIDS Interfaith Network, said he recently learned his agency is facing an additional $202,000 in cuts for transportation services this year. Combined with the roughly $300,000 in cuts for AIN due to the changes implemented by the county last year, the organization has lost about one-third of its entire budget.

In addition to other services, AIN provides transportation to 1,500 clients a year, primarily to and from medical appointments.

“We’re still providing everything that we had been providing, but that may change in the next few weeks depending on what I can come up with to override this $200,000,” Pace said. “It’s not easy. A lot of difficult decisions are right on top of us.”

Pace said he hopes that in the future many of the support services will be recategorized as core medical services.

Karin Petties, assistant director for Ryan White grants compliance at county Health and Human Services, said in addition to mandating the 75/25 split, Congress changed the criteria for awarding Ryan White funds to counties. Previously, it was based half on the number of AIDS cases in a county, and half on a competitive bidding process. Under the updated act, most funding known as formula funding is based on the number of HIV and AIDS cases combined in a county, with the remainder known as supplemental funding based on a competitive bidding process.

Dallas County already has been awarded the formula amount, which went up from $6.4 million in 2006 to $9.1 million this year, Petties said. However, Ryan White funding for Dallas County is down $3.1 million overall in 2007 pending the supplemental amount and about $1 million in Minority AIDS Initiative monies that will be awarded in August.

In the past, Petties said, the county has known by March 1 how much Ryan White funding it will receive.

But this year, because the act made five new areas of the country eligible for funding, there has been a delay in the grant process.

Petties said she believes it’s possible the supplemental amount will result in an overall increase in Ryan White funding to help offset for support services the switch to the 75/25 split. The county could learn as early as Monday, April 30 what the supplemental amount will be.